CPT 01850: Anesthesia for Veins of Forearm, Wrist, and Hand
CPT code 01850 designates anesthesia services for procedures on the veins of the forearm, wrist, and hand. It covers anesthesia delivered for distal upper-extremity venous interventions and serves as the code of record when no more specific anesthesia code applies. Nationally, this code matters because it informs billing and coverage for a common class of outpatient and inpatient vascular procedures affecting the hand and forearm.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn how 01850 is defined clinically, where the service is typically delivered (ambulatory surgery centers, hospital ORs, procedure suites), and which payers commonly cover these anesthesia services. The publication provides benchmarks and policy context relevant to billing, clarifies typical sites of service, and outlines the clinical circumstances under which this anesthesia code is used. Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 pairings is noted where applicable.
Sign up for cpt 01850 policy alerts
Get alerted when payer policies referencing 01850 are released or updated.
Billing Code Overview
CPT code 01850 describes anesthesia services provided for procedures on the veins of the forearm, wrist, and hand. This code is used when the anesthesia provider performs care specifically for venous procedures of the distal upper extremity and for anesthesia services not otherwise specified by other anesthesia codes.
-
Service type: Anesthesia for venous procedures of the forearm, wrist, and hand
-
Typical site of service: Ambulatory surgery centers, hospital operating rooms, and procedure suites where venous interventions on the distal upper extremity are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with symptomatic superficial venous insufficiency of the forearm presents for surgical ligation and microphlebectomy of superficial forearm veins under monitored anesthesia care. Pre-procedure, the anesthesia provider evaluates comorbidities (hypertension, controlled diabetes), reviews medications and allergies, obtains informed consent for anesthesia, and assigns an ASA physical status (commonly P2 or P3). On the day of service the patient is transported to an ambulatory surgery center or hospital outpatient department: intravenous access is established, standard ASA monitors are applied, and sedation/analgesia is administered (often MAC with propofol or midazolam/fentanyl). Local tumescent anesthesia may be used by the proceduralist; the anesthesia professional documents airway management, intraoperative course, hemodynamic stability, any intra-procedural complications, and recovery disposition. This service is coded using 01850 for anesthesia services specific to procedures on veins of the forearm, wrist, and hand when no more specific anesthesia code applies. Typical sites of service include an ambulatory surgery center, hospital outpatient department, or tertiary hospital operating room.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual Anesthesia | Use when medically necessary but no surgery performed or when severe local inflammation/disease requires unusually deep anesthesia for the venous procedure. |
50 | Bilateral Procedure | Use if identical venous procedures are performed on both forearms/hands and payer requires bilateral modifier for anesthesia billing. |
52 | Reduced Services | Use when the planned anesthesia service was partially reduced or not completed as documented. |
53 | Discontinued Procedure | Use when anesthesia care is terminated due to patient-related or surgical factors before completion. |
54 | Surgical Care Only | Use when the anesthesia provider documents that another clinician provided the anesthesia and the billing pertains only to the surgeon’s intraoperative care (rare for anesthesia billing). |
55 | Postoperative Management Only | Use when the anesthesia professional provides only postoperative management and not the intraoperative anesthetic. |
56 | Preoperative Evaluation Only | Use when only the preoperative evaluation is provided by the anesthesia professional. |
62 | Two Surgeons | Use when two surgeons with distinct specialties simultaneously perform complex venous repairs requiring additional anesthesia resources. |
78 | Return to OR for Related Procedure | Use when patient returns to the operating room for a related venous procedure during the postoperative global period and additional anesthesia is provided. |
AA | Anesthesia by Anesthesiologist | Use to indicate the anesthesiologist personally performed the anesthesia service. |
AD | Medical Direction by Anesthesiologist | Use when the anesthesiologist medically directs qualified non-physician anesthetists. |
QK | Medical Direction of Two, Three, or Four Certified Registered Nurse Anesthetists (CRNAs) | Use when the anesthesiologist directs multiple CRNAs during the venous procedure. |
QS | Monitored Anesthesia Care (MAC) | Use when MAC is provided and reported per payer instructions for anesthesia services. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2084P0201X | Anesthesiology | Anesthesia professionals who provide MAC or general/regional anesthesia for forearm/hand venous procedures. |
207L00000X | Surgical Assistant | Surgical specialists who may assist in venous procedures; relevant when modifiers like 62 apply. |
207K00000X | Surgeon | Vascular or hand surgeons who perform the operative venous procedures and coordinate with anesthesia. |
207XS0113X | Emergency Medicine (consult) | May be involved for perioperative optimization in complex comorbid patients. |
3336K0002X | Pain Medicine | Interventional pain specialists may perform vein-related procedures in some settings and coordinate anesthesia needs. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I83.90 | Varicose veins of unspecified lower extremity without ulcer or inflammation | Not directly for forearm veins but represents common venous pathology; included for context when varied venous disease coding is applied. |
I87.2 | Venous insufficiency (chronic) (peripheral) | Chronic venous insufficiency can affect superficial veins of the upper extremity and prompt procedures on forearm/hand veins requiring anesthesia. |
I83.111 | Varicose veins of right lower extremity with ulcer of thigh, with inflammation | Example of venous disease severity; venous pathology coding often parallels procedural indications though specific upper extremity codes may be used. |
I83.119 | Varicose veins of unspecified lower extremity with ulcer of thigh, without inflammation | Illustrates chronic venous disease presentations that may necessitate venous interventions. |
R22.31 | Localized swelling, right upper limb | Swelling of the forearm/hand can be associated with venous disease prompting diagnostic or therapeutic venous procedures. |
R22.32 | Localized swelling, left upper limb | Same relevance for left-sided presentations. |
I80.89 | Phlebitis and thrombophlebitis of other sites | Acute inflammatory venous conditions of the forearm/hand that may require operative management with anesthesia. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36465 | Endovenous ablation of incompetent vein, extremity, radiofrequency; percutaneous, inclusive of all imaging guidance and catheterization | Often performed for superficial venous insufficiency of the forearm/upper extremity and may be done under the same anesthesia encounter as 01850. |
36470 | Injection of sclerosant for uncomplicated superficial veins; single vein | Sclerotherapy may be performed before or after anesthesia for focal forearm or hand veins and billed separately from anesthesia. |
37700 | Ligation, division, and excision of varicose veins, superficial; ligation of more than one truncal vein at saphenofemoral or saphenopopliteal junctions — upper extremity equivalent procedures coded by specific vein excision codes | Surgical venous procedures on the forearm/hand that require anesthesia services reported with 01850. |
36478 | Endovenous ablation of incompetent vein, extremity, laser; percutaneous, inclusive of all imaging guidance and catheterization | Alternate endovenous modality commonly used in the same clinical workflow and requiring anesthesia management. |
20610 | Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder) | May be performed in the upper extremity setting for regional analgesia or diagnostic reasons during the perioperative course; occasionally performed in the same episode of care. |